Ian Davidson MA PhD MCSP SRP

Ian Davidson, School of Nursing, Midwifery and Social Work, University of Manchester, Oxford Road, Manchester M13 9PL, UK. E-mail: ian.davidson@manchester.ac.uk

Abstract

Aims. This paper reports a study which aimed to explore the effects of education on the practice of nurses working in stroke rehabilitation units.

Background. It has been suggested that a key component of the success of stroke units in reducing mortality and disability is the contribution made by nurses, but debate continues around their specific role. Literature has concentrated on nurses’ perceptions of their role rather than their actual activities with patients. In studying the effects of education on nurses’ practice with stroke patients there is a need to identify what nurses actually do, rather than what they say they do.

Methods. A quasi-experimental, non-equivalent control group design was used to study two stroke rehabilitation units. Non-participant observation was conducted during morning care sessions, focusing on styles of physical interaction. Base-line observations were recorded in each unit, after which the staff in the intervention unit received 7 hours’ education, specifically focused on therapeutic handling in relation to morning care activities. Following this, postintervention observations were conducted and comparisons of interaction styles made between units.

Results. Twenty-six staff and 37 patients took part in the study. Following the education, staff in the intervention unit showed a change in physical interaction style more in line with therapeutic practice, with the proportion of ‘doing for’ interventions reducing (45·4% vs. 33·2%; P < 0·05). The proportion of facilitatory interventions increased (3·9% vs. 6·1%) however, this difference was not statistically significant (P = 0·098). The change in styles of practice was achieved with no increased demand on nurses’ time.

Conclusion. Education for nurses which aims to change styles of interaction with stroke patients can be effective. However, further research is required to identify the effect of nursing interventions on patient outcomes following stroke.